Pre-Bolusing and Still Spiking? Check Your Carb Count | Type 1 Diabetes episode artwork

EPISODE · Aug 14, 2026 · 6 MIN

Pre-Bolusing and Still Spiking? Check Your Carb Count | Type 1 Diabetes

from Your Best T1D Year · host Neil Greathouse

You pre-bolus. You give it the 15 minutes. You watch the arrow. And you're still spiking. Don't throw out the challenge, that spike is a clue. Neil puts on the detective hat, because timing is huge, but it isn't the only dial on the dashboard.If your timing's perfect and you're still climbing, the amount may be the problem, and the most common culprit is the carb count. A study by Brazeau found that adults with type 1, averaging 21 years of experience, were off by about 15 grams of carb per meal, roughly 21% of the plate, and underestimated 63% of the time. Neil walks through the other usual suspects too, fat and protein, stress, hormones, and exercise, and how to troubleshoot with your care team.In this episode:Why perfect timing doesn't always fix a spikeThe Brazeau study: even veterans miss carb counts by about 15 gramsThe other suspects: fat, protein, stress, hormones, exerciseHow to play detective on one meal without changing doses soloThis Week's Challenge: If you're pre-bolusing well and still spiking, play detective on one meal. Weigh or honestly eyeball the carbs, see if the count was off, and bring what you find to your care team.Helpful resources and newsletter: https://yourbestt1dyear.comConnect with Neil: TikTok: https://tiktok.com/@the.betes Instagram: https://instagram.com/thebetes Facebook: https://facebook.com/neilgreathouse LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 Website: https://yourbestt1dyear.comBooks on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1

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Pre-Bolusing and Still Spiking? Check Your Carb Count | Type 1 Diabetes

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